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Contractility Measurements on Isolated Papillary Muscles for the Investigation of Cardiac Inotropy in Mice
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[Papillary muscle rupture as a manifestation of SLE in the puerperium]

Diogo Rijo1, Sara Simões Costa1, João Pedro Monteiro1

  • 1Serviço de Cirurgia Cardiotorácica, Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal.

Revista Portuguesa De Cirurgia Cardio-Toracica E Vascular : Orgao Oficial Da Sociedade Portuguesa De Cirurgia Cardio-Toracica E Vascular
|June 14, 2018
PubMed

Insights

Systemic Lupus Erythematosus (SLE) and Antiphospholipid Syndrome (APS) can cause severe heart issues. A postpartum woman with SLE experienced sudden heart failure from papillary muscle rupture, leading to a catastrophic APS diagnosis.

Area of Science:

  • Cardiology
  • Rheumatology
  • Immunology

Background:

  • Systemic Lupus Erythematosus (SLE) and Antiphospholipid Syndrome (APS) are autoimmune disorders.
  • Both conditions can lead to significant cardiovascular complications, particularly when co-occurring.

Observation:

  • A young woman in the postpartum period presented with acute SLE.
  • She rapidly developed heart failure due to papillary muscle rupture.
  • The patient underwent emergency mitral valve replacement surgery.

Findings:

  • The final diagnosis was Catastrophic Antiphospholipid Syndrome (APS).
  • This was confirmed by antiphospholipid antibodies and multi-organ thromboembolic events with cardiac micro-thrombi.
  • The patient had a successful surgical outcome with no major postoperative complications.

Implications:

  • Catastrophic APS is a rare but life-threatening condition with a high mortality rate (around 50%).
  • This case highlights the critical cardiovascular risks associated with SLE and APS, especially during the postpartum period.
  • Prompt diagnosis and aggressive management, including surgical intervention, are crucial for improving outcomes in these complex cases.

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